By Joel Magalnick, Editor, JTNews
The level of frustration in the room could have been measured with a yardstick. During a comment period, dozens of people — some elderly, some disabled, some immigrants, some not directly affected — stood up to express their need to see the health care system in this country undergo drastic change. But that was just part of the two-hour-long event that took place on Aug. 12 in the sanctuary of Temple B’nai Torah, billed by the Healthy Washington Coalition as a health care caucus.
With the cost of health insurance in this country rising and quality of care in many instances falling, the reality is stark: According to statistics presented by the coalition of more than 90 organizations throughout the state, a quarter of the state’s residents are underinsured, and of that segment of the population, more than half have put off necessary medical procedures due to lack of coverage.
“This is not something that’s elective,” Dr. Michelle Terry, a pediatrician at Children’s Hospital in Seattle, told the audience of about 250. Many of these procedures are “to correct congenital anomalies, to reconstruct after accidents, to reconstruct after cancer…. Insurance companies aren’t paying anymore.”
Many pay for minimal insurance at costs that match or exceed mortgage payments, Terry said. After debilitating illnesses or surgeries, people are often unable to work — and therefore must give up their jobs, meaning they also lose their insurance coverage — which puts them in financial jeopardy. That has likely been the case for the estimated 19,000 Washingtonians who have filed for bankruptcy due to medical issues.
But, Terry added, the rising costs of health insurance are affecting everyone.
“Even families with insurance are paying more in out-of-pocket medical costs,” she said.
Terry was one of several speakers at the caucus, the fifth of seven held around the state, including one held in Tacoma at Temple Beth El. The Healthy Washington Coalition is a nonpartisan mix of religious organizations, including Congregation Beth Shalom and the Washington Coalition of Rabbis, labor unions and various nonprofits who want to see a more equitable and accessible health care system in Washington State.
Health care costs also have a huge impact on the state’s budget. An estimated 35 percent of emergency room visits could be better handled in a primary care setting, Terry said. That could have saved the state more than $550 million in 2006.
According to a report by the state’s insurance commissioner Mike Kreidler, more than a quarter of those costs came from King County alone.
“We already have universal coverage,” said Kreidler in a Sept. 2006 news release. “How? Because the uninsured do receive health care – it’s just that we all pay for their care. And they often get their care in emergency rooms – the most expensive and least effective setting. Until we do something to address the growing number of uninsured, we will continue to see our costs rise.”
A plan being set forth by Kreidler would allow insurance companies to augment a universal, statewide catastrophic-coverage plan through employers or individuals.
The state has contracted with an independent research firm, Mathematica Policy Research, Inc., to look at five options, including Kreidler’s, for providing coverage in the state that range from the status quo to full, state-provided coverage for everyone. In all cases, individuals and employers would bear some of the cost. Results of the audit will likely come by the end of the year.
Kreidler’s solution, something of a middle road, would not necessarily sit well with many of the attendees at the health care caucus.
Jo Merrick, a member of Temple Beth Am, stood up and said that as someone who has been insured under military plans throughout her life, it was possible to expand that type of coverage to the entire country in a way that could be affordable and regardless of employment.
“We should stop and look at how that works, because the government can do it,” Merrick said.
At each of the seven caucuses, participants were asked to get into small groups and decide, from a list of 12 options, their top priorities to recreate the state’s health care system. Combined results from each caucus will be sent to legislators. The most supported option — by a landslide — was broad but clear: Cover everyone.
“It’s doable,” said Wayne Bergman, a participant who spoke during the comment period. “The only question is how to pay for it.”
Though many people look to Canada’s national health system as a model for what Washington could provide, Bergman called that system unsuccessful and instead pointed to France as a better alternative.
“If we’re going to get this through…we need to provide our legislators with a blueprint,” he said. “If we give them a plan that works, we’ve got it made.”
Whatever happens, any change in health care won’t happen without a fight. Companies like Regence Blue Shield, the state’s largest insurer, acknowledge that the health system is broken, but the nonprofit sees the future of health care as a “value-driven system,” which focuses primarily on cost of care, according to its website. Removing health insurance from the employer would likely be a stumbling block.
“The freedom of not relying on the employer for coverage will create a bevy of new concerns,” wrote Bob Graham, executive editor of Insurance & Financial Advisor magazine in an article dated Aug. 11. “They include fear of rationing, delays in care and, no doubt, an increased tax burden on consumers who must ultimately foot the bill for greater access to health care. That will retard any efforts to expand business in this nation, much as the mortgage crisis and oil concerns have slowed business this year.”
Still, a survey by the Commonwealth Fund, a private foundation with a mission of overhauling the nation’s health care system, noted that 82 percent of Americans believe the current system needs to be fundamentally rebuilt.
“It’s a complicated issue, there are many profit centers of the health care industry,” said Robby Stern, chair of the Healthy Washington Coalition, as the caucus closed. “Opposition to comprehensive change is going to be ferocious. With determination, we can make it happen.”